Infectiou Diseases in Pyrexia of Unknown Origin Patients in Community Hospitals in Public Health Region 1, 2004

Abstract

The purpose of this cross-sectional descriptive research was to study the etiology of acute illness based on laboratory investigations and epidemiology characteristics in community hotpitals in two provinces in Public Health Region 1 selected by simple random sampling, during January-December 2003. Target patients were those over 10 years old, running temperature at over 38.3ºC without definite diagnosis emerging from histories and physical examinations. Paired serum of each patient were collected at a 12-14 day interval for laboratory examinations. Their medical records were assessed and compilation of data was made by descriptive statistical analysis and comparion was made with epidemiological reports in respective areas.

Among 126 subjects in the study, 73.8 percent were in-patients, 54.0 percent females, 38.9 percent aged 25-45 years and 57.9 percent employees. It took 70.6 percent of them less than 5 days from the onsets of illness to see physicians. The subjects reported the symptoms of chill (41.3%), cough (40.5%) and myalgia (37.3%). Laboratory examinations were complete blood count (73.6%), urine analysis (58.6 %) and Widal test (25.4%). Their diagnoses included pyrexia of unknown origin (46.0%), enteric fever (11.1%) and dengue infection (6.4%). However the laboratory investigations of their paired serums revealed dengue viral infection (25.4%), influenza (6.3%), leptospirosis (4.0%), melioidosis (4.0%) and scrub typhus (2.4%). No case of typhoid and malaria were reported. Such similarities were also observed when data from epidemiological reports in respective areas were compared. There should be efforts to develop guideline to identify the causes of acute febrile illnesses, supporting standard laboratory examinations and effective surveillance system to properly prevent and control infectious diseases.